“As the world’s largest and leading collective of medical professionals in surfing the European Association of Surfing Doctors (EASD) is actively contributing to and defining standards for surfer welfare. By connecting health professionals representing all medical specialties with a passion for surfing and the ocean, the EASD seeks to share knowledge, expertise, and experience with the global surf community. In a fast developing global surf community, the EASD’s quest is to “Keep the surfer healthy and safe” through numerous activities, such as: treatment in day-to-day practice, serving as contest medical personnel in both professional and amateur surfing arenas, delivering training courses for medical lays and health professionals alike (Surf Life Support™), conducting scientific research work and publication, defining evidence-based standards within the specialty and the sport at large, and convening the Annual Conference in Surfing Medicine where health professional from all over the world convene. Share the passion? See you on one of the various EASD events and in the water!”

The European Association of Surfing Doctors (EASD)

PRESENTS

“The Surfing Medicine Global Outreach Report 2015”

The European Association of Surfing Doctors (EASD) is proud to present the 2nd Surfing Medicine International Community Global Outreach Report. The EASD is a medical, non-profit organization grounded in a commitment to excellence, in the application of state-of-art knowledge, evidence-based science, and transparency to surfer welfare, and in staging 100% certified Continued Medical Education (CME) educational events.

Since our founding four years ago, 120 projects have been successfully realized. We started out with “A Passion for Surfing and Medicine”; with time, dedication, and a lot of hard work, we have developed into the leading medical organization committed to “Keeping the Surfer Healthy and Safe”.

EASD Global Outreach 2015, only a few white spots left!

Presently, professionals from 31 countries working 24/7 on original science and surfing medicine research are establishing the foundations and necessary framework for new, evidence-based standards within surfing, and implementing the gained knowledge and experience won in order to contribute meaningfully to the further improvement and professionalization of surfing medicine and the sport we love dearly. From 373 in 2014, we have grown to 510 members in 2015, representing the largest community of surfing doctors worldwide.

In 2014, the EASD reached out to the big wave community by “Taking Surfing Medicine to the Extreme” at the 3rd Annual Surfing Medicine Conference in Ireland. Designed and delivered by 2013 Billabong XXL Finalist, Peter Conroy, the EASD organized the world’s first multiple-specialization, medical-response PWC rescue training for surfing, sharing our knowledge, experience, and defining new standards and approaches to the safety, prevention, and treatment of emergency situation in big wave surfing.

Convening Conferences with unique people, realizing projects new to the world of medicine and surf science, and consistently exceeding the expectation of expert collaborators; by building on the knowledge of hundreds of medical doctors, academic professors and applied scientists, allied health professionals, and educating the surfing public, whether the everyday surfer or top professional surfing athletes, the EASD is growing from strength-to-strength year on year.

With 2015 well under way, the EASD and the Surfing Medicine International community is once again preparing for the gathering of minds and surfboards at the 4th Annual Surfing Medicine Conference. This year, returning to “The Core of Surfing Medicine”, we are unifying the world’s leading experts on drowning prevention and delivering another first in the form of the world’s largest Drowning Resuscitation Workshop yet seen. Stoked? We are too!

See you in Pays Basque (France) at Conference 2015 in Anglet/Biarritz this September!

Mindfulness and Surfing In-The-Now …

What kind of images does the term mindfulness evoke for you? You’d be forgiven for jumping straight to the scene shown inset given the recent heightened enthusiasm and zeal for mindfulness and the promotion of all things mindful by new–age ‘wellness’ industry types. Certainly, for healthcare professionals, whose practice supposedly emanates from scientific evidence – although the legitimate question could often be asked, how many of the interventions we advocate are truly underpinned by robust (complete, unbiased, open-access) scientific data, as opposed to inherited and unquestioned established practice – the area of mindfulness and how to approach it is commonly greeted with an uncomfortable awkwardness. Perhaps this reaction is nothing more than diffidence, or maybe even a healthy professional scepticism, the result of a scientific training. So we thread cautiously, perturbed by the meeting of two seemingly incompatible worlds, a curious juxtaposition; that of scientific endeavour, and that of Vipassana (Insight) meditation, derived from the Buddhist tradition, from which mindfulness originates.

Before I lose any ardent scientists, it is worth reminding ourselves that Buddhism is not a religion, rather an ethical tradition. Secondly, the practice of mindfulness does not imply reclusive contemplative asceticism requiring prolonged immobility in a monastery set high in the Tibetan Himalayas. Although, such a serene environment would almost certainly be conducive to any meditative practice regardless of its tradition of origin! Mindfulness, or the act of being mindful, is a practice that can be incorporated into any daily activity. In the scientific literature, mindfulness (1) has been defined as:

“the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to things as they are”

The exploration of mindfulness-based practices and their therapeutic applications within ‘conventional’ medical/behavioural and cognitive therapy circles began in the late 1970s through the work of Jon Kabat-Zinn. He set up the Stress Reduction Clinic at the University of Massachusetts Medical Center in Worcester in 1979. Kabat-Zinn and colleagues offered Mindfulness-Based Stress Reduction (MBSR) to people with a range of conditions, including chronic pain, panic, anxiety, stress-related GI problems, headaches, sleep disorders, even heart disease, hypertension, AIDS, and cancer. By the early 1990s, they had evaluated the efficacy of their approach to anxiety (2) and chronic pain (3). The evidence demonstrated that most patients experienced sustained physical and psychological symptom reduction. Moreover, they also reported a positive change in attitude, behaviour, and self-perception, and that of others and the world at large.

Encouraged by this latter phenomenon, three psychologists, Zindel Segal, John Teasdale, and Mark Williams, embarked on a journey in the mid 1990s to develop a relapse and recurrence prevention therapy program to help patients with recurrent depression stay well. Ultimately, incorporating elements from cognitive behavioural therapy, drawing on the pioneering work of Aaron Beck (4,5) during the 70s and that of others, in combination with mindfulness-based practices and after much experimental work, research, and clinical evaluation, they successfully developed a maintenance cognitive therapy grounded in the practice of mindfulness now known as Mindfulness-Based Cognitive Therapy (MBCT). In 2003, at the time of publication of the first edition of “Mindfulness-Based Cognitive Therapy for Depression” by Segal, Teasdale, and Williams, there was only a single trial showing that the intervention was efficacious, and a total of 52 publications that year concerning ‘mindfulness’ in the scientific literature. Ten years later, upon release of the second edition (6), there were five additional research trials evaluating MBCT – including two which compared MBCT to the most commonly used relapse prevention treatment: antidepressant medication – and, in 2011, 397 ‘mindfulness’ related scientific publications that year. The evidence is clear and highly consistent: MBCT is highly effective in relapse reduction for patients with the longest and most recurrent history of depression.

What Lies Beneath? Photo Credit: Dustin Humphrey Photography

The process of bringing our mind to stillness and cultivating awareness in a systematic way is mediated by following our breath. In life, our breath is ever present. Hence, it is the perfect object on which to focus our attention. By drawing our attention to our breath we can remove the continuous, ruminative noise of the mind. In doing so, we access the present moment, free from past reminiscences and future imaginings and awaken to our experience.

Whether we, as surfers, recognise or not, the very act of riding waves behoves awareness of the present moment. The ocean wave itself is a transient, malleable form ever changing in response to any number of variables … bathymetry/bottom contour, wind direction, swell characteristics, even another surfer positioned further out on the shoulder duck diving, and in doing so, hastening the green face to break prematurely.

Interested?

Manel Saltor will lecture on The Mindful Surfer – Mindfulness Meditation – Mental Preparation. Manel hails from Barcelona in the Cataluña region (Spain) and is a life-long surfer and practitioner of Vipassana and Mindfulness meditation. He began practicing at the age of 24, doing multiple retreats and workshops in Buddhist philosophy and psychology. He has studied and practiced with the disciples of Ajaan Buddhadasa – a great Therevada Buddhist Monk, founder of the Suan Mokkh Monastery, and one of the six most important Vipassana Meditation teachers worldwide. Manel has taught Mindfulness and Vipassana meditation in a number of countries across the globe. His passion for sport, surfing, and the ocean, combined with his understanding of the mind and life led him to develop a mindfulness-based mental training methodology for surfers, the Mindful Surfer workshop.

Keynote Speakers (A-Z)

Dr. Guillaume Barucq (Basque coast, SW France)

Guillaume Barucq is a 37-year-old surfer and general practitioner from the Basque coast in France. He works in Biarritz, close to some of the best surfing spots that the Basque coast has to offer. In 2008 he launched Surf-Prevention.com, a website originally intended to educate doctors of the risks of surfing, common injuries and how to minimize the risks associated with the sport. Now almost eight (8) years down the line, he is still the editor of Surf-Prevention and is also an occasional blogger for theinertia.com, with a main focus on promoting surfers’ health, the benefits of surfing and environmental protection. He is a firm believer in the role of seawater, sea air and the marine climate in helping to strengthen our health and prevent illness, and is also a defender of the marine environment because our health is intimately related to the health of the ocean.

He is the author of “Surfers’ Survival Guide” and “Surf Therapy”, two very well sold, French-language health books for surfers. He is also involved in surfing medicine research, and in 2007 he published a study on surfing-related traumatology based on 350 patients admitted to the hospital after surfing accidents in the South West of France. Dr. Barucq studies the benefits of surfing for health and the different medical applications of “Surf Therapy” for people with disabilities, autism, cystic fibrosis and other diseases.

Dr. Joost Bierens MD PhD MCDM (The Netherlands)

Dr. Joost Bierens, MD PhD, (The Netherlands, 1954) studied medicine in Nijmegen (NL). He was trained as an anaesthesiologist in Leiden (NL) and emergency physician in Leuven (Belgium). After he completed his training, he worked as an anaesthesiologist and Intensive Care physician (Venlo, NL) and head of the department of Intensive Care and Hyperbaric Medicine (Antwerp, Belgium). At this moment he is the head of the Department of Anesthesiology of the VU University Medical Center in Amsterdam (NL). In February 2002 he was appointed as Professor in Emergency Medicine at the Department of anesthesiology. The hospital has a function as a supra-regional level I trauma centre and is the ground station for a helicopter mobile medical team. His major fields of attention include emergency and disaster medicine.

The scientific interest in water-related injuries started when he worked as a professional lifeguard during medical school vacations. During his medical career he published more than 80 articles and chapters on drowning, hypothermia and water safety. In 1996 he completed the PhD thesis “Drowning in the Netherlands. Pathophysiology, epidemiology and clinical studies”. He is a regular national and international invited speaker and teacher on these subjects, from a practical rescue level to the clinical intensive care level. He is affiliated to several organisations in this field such as the Royal Dutch Orange Cross, Royal Dutch Lifeboat Institution and the Medical Commission of the International Life Saving Federation. Since the origin of the idea to obtain a global focus on the issue of drowning in 1996, he serves as project co-ordinator of the World Congress on Drowning.

In addition to the activities in the field of water safety, Dr. Joost Bierens is involved in research, education and strategy planning in several other fields such as intubation, infection prevention, medical ethics, diving medicine, resuscitation, emergency medicine and disaster medicine. He has published several articles and chapters in books and presented scientific papers on these topics. He is a member of the Editorial Board of the European Journal of Emergency Medicine.

Biography

Drowning – An Overview of the revised handbook. Maatschappij tot Redding van Drenkelingen (Society to Rescue People from Drowning).

Dr. David Szpilman (Brazil)

David Szpilman graduated from medicine in 1982. He completed his medical residency jobs during 1982 to 1985 as a specialist in internal medicine and intensive care with a focus on drowning, after which he quickly became head of the intensive care unit of the Hospital Municipal Miguel Couto in Rio de Janeiro, Brazil. Additionally, he became the doctor for the Fire Department in the State of Rio de Janeiro where he was head of the Drowning Recovery Center for 12 years. His current roles involve; board member of medical commission of International Lifesaving Federation (ILS); founding partner, ex-president and current medical director of the Brazilian society of aquatic rescue – SOBRASA; member of the Technical Chamber of sports medicine of the CREMERJ; medical reviewer of journals “Resuscitation” and the “New England Journal of Medicine“. He is the author of 4 books, 61 book chapters and more than 127 national and international medical articles on drowning. He is a frequent guest lecturer worldwide, and has presented at many conferences across the globe; 390 lectures in Brazil, and 22 International (Belgium, Hungary, England (2), Spain (3), UNITED STATES (4), Argentina (3), Venezuela, Uruguay, Italy, the Netherlands, Portugal (2), Ireland, and Australia).

Prof. Mike Tipton (Portsmouth, UK)

Educated at the Universities of Keele and London, Prof. Tipton joined the University of Surrey in 1986. After 12 years at the Robens Institute and European Institute of Health and Medical Science he moved to the University of Portsmouth in 1998. In addition to his University positions, Professor Tipton was based at the Institute of Naval Medicine (INM) from 1983 to 2004 and was Consultant Head of the Environmental Medicine Division of the INM from 1996. He has spent over 30 years researching and advising the military, industry and elite sports people in the areas of thermoregulation, environmental and occupational physiology and survival in the sea. He has published over 500 scientific papers, reports, chapters and books in these areas.

Professor Tipton has been a Consultant in Survival and Thermal Medicine to the Royal Air Force and UKSport; he sits on the Royal National Lifeboat Institution (RNLI) Medical and Survival Committee, and the Ectodermal Dysplasia Society’s Medical Advisory Board. In 2004, Prof. Tipton was made an Honorary Life Member of the International Association for Safety & Survival Training (IASST) in recognition of his work in sea survival. He chaired UKSport’s Research Advisory Group and now sits on the English Institute of Sports’ Technical Advisory Group. Prof. Tipton chairs the Energy Institute’s Health Technical Committee; he a Trustee of Surf Lifesaving GB and Senior Editor of the journalExtreme Physiology and Medicine. Prof. Tipton is a Fellow of the Royal Society of Medicine, he provides advice to a range of universities, government departments, industries, medical, search and rescue, and media organisations.

Dr. Brian Tissot (California, USA)

Professor Tissot is a surfer and a marine ecologist with over three decades of experience conducting research on temperate and tropical marine ecosystems. He received his Ph.D. in Zoology from Oregon State University and has held positions at the University of Hawaii and Washington State University. He currently serves as the Director of the Marine Laboratory at Humboldt State University and lives in Trinidad, CA. He has published over 70 papers in scientific journals and has been awarded over $7 million in research grants in his career and serves on multiple scientific advisory boards. Brian’s work has been featured in Scientific American, Smithsonian magazine, the Washington Post and several films.

His Benthic Ecology Laboratory is focused on scientific research that improves the understanding, management and conservation of marine ecosystems. In collaboration with local communities, agencies, and a variety of other organizations, he develops and implements innovative solutions to marine resource issues. Working in Hawaii for the last 20 years, Dr. Tissot and his colleagues have improved the management of the aquarium fishery along the Kona coast by developing a community-based, collaborative research program on marine protected areas. Along the California and Oregon coasts he has worked on deep sea fisheries and their effects on structure-forming invertebrates and his research has been used to formulate management strategies for bottom trawling and protecting essential fish habitat.

In addition to his scientific research Tissot (aka “Dr. Abalone”) also produces surfing videos on YouTube and blogs about surfing, marine biology and environmental issues on his site BrianTissot.com.

Biography

Coming Soon …

Stay tuned to the Homepage / Facebook / Twitter / Instagram / Vimeo over the coming days and weeks for more information on the 4th Annual Conference in Surfing Medicine and Keynote Speaker announcements!

“Rip Currents … What Every Water User Needs to Know” by Tim Jones

Rips are, to most of us, a fantastic aid to our surfing when understood. They help us pass out through waves to the takeoff area and often they define the “peak” and create a better breaking wave.

So what are rips? A definition from the US Coast Guard …

RIP CURRENTS ARE POWERFUL CHANNELS OF WATER FLOWING QUICKLY AWAY FROM SHORE … WHICH OCCUR MOST OFTEN AT LOW SPOTS OR BREAKS IN THE SANDBAR AND IN THE VICINITY OF ROCKS AND STRUCTURES SUCH AS GROINS, JETTIES AND PIERS

However, they can also be a source of danger especially to those who are unaware of their existence. So here are a few interesting facts and basic statistics.

Annually, in the US, there are on average 100+ deaths from rips. In the UK, two in every three (2/3) water rescues are because of rips. Rips in the UK account for more deaths than bicycle accidents!

In Australia (2004‚ 2012), deaths per year attributable to Rips = 21; Cyclones = 7.5; Bush fires = 5.9; Floods = 4.3; and Sharks = 1. So when many beach goers in some parts of the world fear a shark attack, they would be far better served to understand and spot rips and respect the dangers they represent.

So how do we change the stats?

We, as surfers, can pass on this basic knowledge to others, surfers, or not. Remembering the US Coast Guard definition above, and observing the simple diagram of how rips work below, we can understand a few key principles.

There are a few different types of rip and these are:

Permanent or Topographic

Fixed

Flash

Travelling or Side Rip. Not long shore drift.

The Permanent or Topographic Rip

Let’s look at how each is defined. Firstly, the Permanent or Topographic rip uses physical features at the beach such as: rocks, piers, groins, sea walls and the water (rip), running out along these features. To help you find it, just look at how next to the feature there seems to be an area of calm water with little or no waves. In this picture below you can see the rip passing along the beach towards the cliffs. This is our Travelling or Side Rip. Then you can clearly see where it passes along the rocks and heads out to sea causing a clear path in the water. Look for the dark blue line with the white water each side. You can clearly see its path along the rocks and out to sea. Check how, as it moves away from the rocks, it loses it power and dissipates.

In this picture from Australia, the lifeguards have placed a coloured dye in the water to define the Permanent or Topographic rip.

The Fixed Rip

It’s quite a misleading name, “Fixed”, as these are rips that stay in one general area of a beach, but can move even up to 100m from one side to another. This is due to the change in density of the sand by wave action and the general topography of the beach. The picture on the right shows the gap in the surf line and the travelling rip which is coming from the left hand side of the beach (looking out to sea) and feeding into the rip.

Of course, we may get more than one type, or even all types, of rips occurring on a beach. Here is a particularly illustrative example. At the top of the picture we see a Permanent or Topographic rip running out by the rocks and road (note the absence of surf) and then below is our fixed rip causing a break in the surf line yet again.

Flash Rips

These often occur when a sand bar on a beach breaks down by wave and tidal action or as the tide moves past an outcrop of rocks. The diagram below illustrates typically how such a rip can arise. As the name suggests, they occur suddenly and can often be a great danger to swimmers who often do not know what to do if caught unawares in them.

How wide are rip currents, how fast can they flow, and where do they go?

On average, rips are typically about 9.5m or 31ft wide, but this is a real average as they can be less or more, and particularly the flash rips ‘begin’ by being very narrow. However, it’s a good rule-of-thumb to remember that they are normally about “as wide as a bus is long”!

They move on average at approximately 6.6kph or 4.1mph. That’s some speed, about the same pace as Olympic 400m Gold Medallist, Sun Yang’s average pace. Little chance then of out swimming or out paddling the rip.

Rips flow out to sea to a distance really depending on the volume of water that’s flowing into the beach. They go to an area we call the Head. So on a small day of surf the rip may stop and form the Head only a few hundred metres out to sea. On a big day of surf you may find it flowing kilometres out to sea. Below is a classic example of a beach break rip leading to a head, but of course heads can be found on reef set ups as well. The famous Sunset Beach in Hawaii is a great example. Lost boards there are often never found again!

Caught in the rip?

Now let’s hope that this advice is not needed if you’re a regular surfer. But do pass it on to others new to the sport or those who are just happy water users anyway. Firstly, prevention, don’t let the situation happen in the first place. Get advice about the beach and the surf you’re using and be able to spot the rips before entry, but more of that later. If someone is stuck in a rip, the first rule is don’t panic, and don’t whatever you do try to paddle or swim against it. Remember how fast it is going and just go sideways and towards the breaking waves that can help you. The picture below is simple and a good example of the action to take.

NOTE: Emerging evidence suggests that simply threading water and waiting for the rip to dissipate may be a prudent approach when caught in a rip. Currently, the approach described previously and illustrated above, i.e. swimming parallel to the shoreline/at right angles to the direction of the rip, is advocated by most surf lifesaving institutions and lifeguard professionals. Further research is required to definitively determine the safest strategy. For further information, check out this insightful article New Scientist article on research conducted at the Naval Postgraduate School (NPS) in Monterey, California, USA.

Know the Emergency Signal

It’s worth keeping in mind that people often want help even if they know what to do in a rip or when they see others caught in a rip. It’s a simple one arm in the air and waved from side-to-side to attract attention. This is like a 112 or 999 call of the sea and should be known by all and passed onto others. Just knowing this could save someone’s life and perhaps your own.

Many beaches now carry signs to remind us as shown here. Of course, just getting advice from locals and particularly lifeguards at beaches is number one. Remember, prevention is always better than cure.

So, we need to be aware of the dangers of rips, but also we may be experienced enough to want to use them to access the best surf.

So how do we spot them?

Here are some simple indicators:

1. A gap in the waves or where waves break then “back-off” (die out) and then reform again. The water moving out either stops the waves, creates a channel, or just stops the wave from breaking.

2. The surface of the water has ripples on it even if there is no wind at all. If there is wind, it seems more wind affected. Again, this is the outward movement of water creating the surface affect.

3. The rip will carry sand, seaweed, derbies and pollution. This is often a very clear indicator of a rip.

Line-ups

In order to help us use rips correctly, or to keep others away from them, we need to develop the skill of using line-ups. These are markers on the beach that help keep position in the best surf zone, and thus getting the best waves.

Also, choosing line-ups keeps others safe. Lifeguards do this all the time, setting safe swimming areas marked by flags. If you check the photo below you could choose many line ups from houses, trees, etc. But never choose objects that may move like an umbrella on the beach or a parked car for example.

So rips, although dangerous to those who are unaware of them, are often our best friends in surfing. Take time to observe the ocean before entering and never be afraid to ask questions. Be aware that some rips will take us out to surf we just can’t and don’t want to handle, and other rips will take us out to the best waves of our lives. The main reason for this article is to get you to transmit this basic knowledge to others so we can all enjoy the ocean in a much safer way. Thanks. Stay safe in the water.

The author carving a roundhouse cutback!

Tim Jones is an EASD Scout, International Surfing Association (ISA)/Surfing Great Britain (Surfing GB) certified Surf Instructor and Coach. He is¬†Director of Surf School Lanzarote. Tim has a long and active history with Surfing GB, beginning the first special needs initiative for surfing in the UK, and continues to contribute to the development of coaching skills within the organisation. The current women’s Welsh Junior and Senior Champion, Emily Williams is coached by Tim, as have past champions in Europe such as Mark Vaughen and Nathan Phillips.

UNSW Australia

“Preparation is key to staying safe” by Peter Conroy

Developing robust ‘in-the-surf’ safety procedures, like those we employ for fighting fires and tackling other emergencies, has long been a personal goal of mine. Surfing safety is quite new to Ireland, as is surfing. Devising procedures for safety in the surf is, relatively speaking, in its infancy. I am, as are other big wave riders globally, still learning what’s best.

It takes many years to learn to surf capably. You are required to learn many things; when to go, when to wait, and always, to risk assess your situation. Years accumulate before you acquire such skills and any degree of competency. Through my experience as a fireman and a rescue operator in the surf, I have lost and saved many lives. I have worked so hard – to the point of physical exhaustion – in rescue scenarios. And why; what is it that drives rescuers do this? It’s not the money, or glory, nor fame of any sort. It’s the knowledge that they have done everything in their power to save someone’s life. Not simply for their own sake, but also for the family and friends of those involved. There is nothing worse than confronting a lifeless body, after pulling from the water, after working so hard in an attempt to save and revive them. That experience is harrowing. The look on friends faces, the anguished scream of a family member. This is something that stays with you forever, something I would not wish upon anyone.

So picture your friend’s face, perhaps a surf buddy. Now hold onto that image for a moment. Now imagine them gone, drowned whilst you were surfing together. A terrible thought, but now consider, could they have been saved by doing something relatively simple?

Saving someone is the easy part. It happens, and you move on. It’s when you can’t save them, and somebody dies, that remains with you for the rest of your life. Sometimes you blame yourself, ruminating “Did I do everything correctly …Could I have done something different?” If I have learned anything in all my years as a lifeguard, paramedic, fire-fighter, swift water rescuer, big wave surfer, and rescue jet-ski/boat operator, equipped with training and practice in each discipline, it’s that things never happen as you read in the book! When it comes down to the wire and the ‘shit-hits-the-fan’ only hands-on training and practical experience get you through. What’s more, it all comes back to basics.

The first basic principle is self safety! Only when you are safe, can you begin to think about another person. This is often forgotten when accidents happen. The hero inside, that’s yearning to help someone else, ends up throwing their own safety aside in the process. In an emergency, be it in or out of the water, the most important person in a rescue attempt is YOU. Without YOU there is no rescue. Ensure before any attempt to help that you are both physically and mentally capable to do so. You might be required to resist and overcome the casualty, who is most probably in a state of shock or panicking. The victim will not act rationally or sensibly. They may even attack, or in the case of drowning, use his/her rescuer as a ladder, believing this will actually help them escape danger.

Always be prepared by planning ahead. Ask yourself the following questions. Have you taken a CPR class? Do you know how to do in-water resuscitation? What are you going to do once the victim is ashore? Have you called for help? Who’s coming to assist you should you get into difficulty trying to get back to shore? These are essential questions any surfer ought to ask themselves before going to help someone in distress, and in particular when surfing dangerous, often remote, surf spots with challenging access. The more dangerous the surf spots are, the higher the risks associated with them. You have to realistically consider whether you are adequately prepared for these risks. One can never completely remove risk in surfing, but risk can be minimised by preplanning what to do in the event of plausible occurrences, e.g. drowning, a broken back, a broken leg, burst eardrum, lacerations, etc.

Do you have access to a jet-ski? Have you received training and instruction on how to properly operate that ski? Regardless of where you stand on the tow-in versus paddle argument, the jet-ski, when operated by an appropriately trained individual, is a powerful tool to assist rescue. Similarly, and something more immediately attainable, such as a basic lifesaving or first aid course could be the difference between saving and losing a life.

We are blessed that no one has been killed to date on these shores, and that there have been relatively few major injuries. However, with the envelope being continually pushed, and more dangerous surf spots attempted, I fear the luck of the Irish is going to run out before long. When that day comes, I hope all involved can look back and say that they reasonably did everything within their power to save the unfortunate person, or at least give them a fighting chance. The principles of resuscitation and CPR are covered in any accredited basic first aid course. If you fail to prepare, then prepare to fail. There are numerous courses on lifeguarding and first aid held regularly and readily accessible. A lack of skills in dealing with a rescue situation in a dangerous place could quite conceivably lead to a needless death, possibly even that of a friend. As unpalatable as that may sound, it pales in comparison to having to look into the faces of family and friends knowing you did not have the relatively simple skills and training to deal with the situation.

Trust me when I say ‘I have been there’, I have stood in court, in the dock, with a victim’s family looking on, and have been asked whether I did everything that could be done. From the training and courses I have undertaken, both professionally for my job and pursuant to my lifestyle choices in surfing, I believe I have built up the necessary skills and competency to honestly say to that, or any other, family: “I did everything in my power to save your loved one. Everything”

When you go out to surf, it’s not your surfing ability that will save someone’s life. It is your basic life support and basic lifesaving skills and experience in white water that will.

So if your friend wipes out on a wave and comes up face-down in the water, what are you going to do? Knowing the basics could make the difference.

Take time-out from your surfing to learn these invaluable lifesaving skills, professional and recreational surfers alike. There will always be waves for you to play on – Forever. The same length of time you’ll feel responsible if someone dies who could have been saved had you only known how.

Peter Conroy is an EASD Ambassador, big wave surfer, current nominee and former Billabong XXL Finalist (2013). He is a Fireman and Paramedic with Dublin Fire Brigade. Peter is a certified Beach Lifeguard Instructor and jet-ski/rescue boat operator. He is also Chair Person of the Irish Tow Surf Rescue Club. Peter has previously lectured on the topic of Jet-Ski Assisted Rescue and Safety in Big Wave Surfing, and delivered a practical jet-ski workshop, at the Third Annual Conference in Surfing Medicine (2014). He will co-instruct surf lifesaving and rescue techniques at the upcoming ASLS Course 2015 later this year.

Watch the Irish Tow Surf Rescue Club in training!

“Cold water immersion – treatment and practicalities in the field” by Dr. Patrick Buck PhD REMT

Treating a drowning or hypothermic casualty in the field will always present a number of challenges for a first responder. Psychological stressors, lack of equipment, unfamiliar terrain and perhaps hostile conditions can combine to make the task formidable.

It is for this reason that pre hospital or First Responder training should focus on preventative strategies, prevention is always better than cure and on imparting a set of simplified methodologies for treating and managing such incidents in the field.

When someone falls into cold water four things happen over time. Firstly they will experience a level of Cold Shock which usually lasts between 1 – 3 minutes (stage 1), followed by Cold Incapacitation, which sets in at around 15 minutes (stage 2) and then Hypothermia which may take 30 – 60 minutes to develop (stage 3). The rate at which hypothermia develops is related to several factors including body composition, clothing at time of immersion, atmospheric conditions, water state and water temperature.

Finally some level of Post Rescue Collapse will occur (stage 4). This is of course providing that the casualty has not already drowned through swim failure. Without a Personal Floatation Device (PFD), many people in cold water will drown prior to becoming hypothermic because as their muscles stiffen and cramp, it will get progressively more difficult for them to keep their airway from becoming compromised.

Post Rescue Collapse, also known as Circum Rescue Collapse or Peri Rescue Collapse, can be, and often is, fatal. An estimated 20% of conscious and viable hypothermic casualties recovered from cold water die as a consequence of Post Rescue Collapse either before, during or after rescue.

The primary goal for a First Responder when treating a hypothermic casualty in a pre hospital setting is to try and prevent further heat loss (core body temperature (CBT) drop). In addition as a ‘cold heart is a fragile heart’, every effort should be made to treat the casualty as gently as possible and to avoid any rough handling. Ventricular fibrillation is a very real possibility in a hypothermic casualty and in many cases will prove fatal if initiated through incorrect handling or improper rewarming strategies.

As most First Responders are unable in a field setting, due to lack of appropriate equipment, to determine a casualty’s CBT, all obviously hypothermic casualties should be considered as serious until proven otherwise. As a consequence a casualty should not assist in their rescue nor be encouraged to partake in their treatment, like removing their own wet clothes.

Clinical signs can provide an indication of the casualty’s level of hypothermia, which may in turn assist in their management.

If a casualty is shivering but is mentally and physically alert and is acting normally then they are most likely just cold or very mildly hypothermic.

If a suspected hypothermic casualty is conscious and shivering then their CBT is most likely at or above 32°C.

If a conscious casualty who is obviously hypothermic but is not shivering then their CBT is probably in the region of 30°C-32°C. Note not everyone shivers.

If paradoxical undressing occurs then the casualty probably has a CBT between 30°C -32°C.

If a suspected hypothermic casualty is unconscious then their CBT is most likely below 30°C. Of course they may have sustained other injuries or have drowned.

Casualty rewarming strategies, where possible, should be initiated in the field.

Rewarming can be achieved using a number of different strategies depending on casualty presentation.

Passive external rewarming.

Active external rewarming.

Active internal rewarming.

A hypothermic casualty with a CBT above 32°C can be treated with insulated blankets, dry clothing, burrito wrapping and warm sweet drinks. They will be able to rewarm spontaneously.

A hypothermic casualty with a CBT below 32°C will require active rewarming management. These casualty’s cannot rewarm spontaneously and will require the addition of heat.

In conclusion it must be stressed that every case should be managed on a casualty by casualty basis. In addition a casualty’s treatment must not compromise other members of the party or group. Multiple casualties present a much more significant challenge for a First Responder in a pre hospital setting.

Finally a Hypothermic Casualty Is Never Dead Until They Are Warm And Dead Unless Patently Dead.

Dr. Patrick Buck, Ph.D REMT, is a marine biologist, educator, adventurer and environmentalist. He is currently Director of Inland Fisheries in the SW of Ireland. Patrick has extensive experience in marine survival and a deep passion for remote medicine and its application in the marine environment. He is currently conducting applied research in the area of marine survival and hypothermia and is specifically interested in modified PFD design to prolong life in austere settings. He is an avid water sports enthusiast with over 40 years experience in surfing, kayaking and marine guiding. Patrick is a director of WATER SAFETY 4 ALL, a ‘not for profit’ organisation dedicated to bringing safety and fun to all water users from all walks of life.

Dr. Buck is the author of “A field guide for the treatment of drowning, hypothermia & cold water immersion incidents”. This guide is available through the WATER SAFETY 4 ALL website: http://watersafety.eu It is also available from Amazon.com as an E-book (immediately) or physical book (from 30th January 2015 onward) at select book shops.

Dr. Everline is a Sports Medicine Physician based on the North Shore of Oahu, Hawaii. He has served as Contest Doctor at numerous World Tour Events, including the Pipeline Masters. He is co-founder of Waves of Health and co-author of “Surf Survival: The Surfer’s Health Handbook”.